Archive for October, 2012

Too many children in the United States lack health insurance and organizations in Indiana are working hard to make sure local residents eligible for Medicaid coverage know it. According to The News Dispatch in Michigan City, Indiana, Covering Kids and Families (CKF) is the driving force behind this movement in Indiana. Lois Tomaszewski details this information in the article “Health organizations discuss children’s health insurance.” Health organizations, medical providers, and school representatives met this week to talk about ways they can get La Porte County children covered by Hoosier Healthwise. This is Indiana’s Medicaid program, which covers health insurance costs for eligible children and families.

CKF works all over the state of Indiana to offer health insurance information and other resources that will help families enroll in this health care assistance. They seek out potential applicants through scouring the demographic and try to help them through the application process and match them with health care providers. On a more intimate level, the La Porte County Coalition works more locally doing the same work as the state organization. Families with inadequate or no health insurance have few choices when trying to care for their children. Some recent examples in the article include a child with a peanut allergy who couldn’t afford a life saving epi-pen to carry with him and a child who couldn’t get an arm cast removed because his family’s health insurance was null and void after moving from another state to Indiana.

State health insurance programs cover things like epi-pens or inhalers for kids with asthma. The Michigan City Area Schools organization looks for potential applicants to the state’s Medicaid program through other assistance programs like those who receive free lunches. 97,000 kids in Indiana are without health insurance, while there are more than 800,000 getting free or reduced lunches. One of the most important steps in getting families to meet with these helpful organizations is to work with them on a meeting place and time that is convenient. Once families are aware of the Medicaid insurance available to them and how it can help their kids, they are grateful for the help. MDWise is the Indiana Medicaid program that is non-profit; there are two other programs in the state. This problem is unlikely to go away, so helping to get more children insured will remain of utmost importance.

If you or a family member have ever suffered from an eating disorder, you probably know how difficult it can be to get your health insurance company to pay for treatment. Kaiser Health News discusses this in an article by Shefail S. Kulkarni entitled “Patients Often Find Getting Coverage for Eating Disorders is Tough.” They talk about a 44-year old woman who has been fighting binge eating disorder for two decades. Since eating disorders like this, anorexia, and bulimia are mental health conditions; coverage is very individualized and hard to classify.

Unfortunately, many people don’t get consistent treatment because their health insurance either doesn’t cover eating disorder treatment or only covers partial or short-term treatment. As with most mental health disorders, treatment can take a long time, sometimes the rest of one’s life. It takes comprehensive care from a primary doctor, nutritionist, therapist, and psychiatrist to treat most eating disorders. Patients say that insurance companies are less than generous with their coverage in these areas compared to insurance coverage for physical ailments. The Eating Disorder Coalition fought hard to get eating disorders classified as “essential health benefits” that must be covered per the Affordable Care Act. They were not successful.

Fourteen million people are suffering from eating disorders right now. But because health insurance companies are suffering with soaring health care costs, eating disorder coverage is often one of the first things to get dropped from insurance. While insurers don’t think this coverage is essential, almost 100% of eating disorder specialists say that denial of coverage for people battling anorexia puts them in a life-threatening situation. Insurance companies argue that since there is not a clear cut treatment program for eating disorders, it is more difficult to provide blanket coverage. Parents of autistic children have run into the same kinds of problems when it comes to coverage of their children’s treatment. After fighting insurers, coverage for autism treatment is now mandated in 31 states.

Eating disorder treatment ranges from nutritionist appointments, group therapy, and antidepressants to hospitalization and admittance to mental health facilities. Once such facility’s worker said that insurance companies are much more likely to pay for treatment for mood disorders than they are for eating disorders. Insurers also are quicker to authorize longer stays when it comes to mood disorder treatment. Patients believe a lot of the problem is with the stigma attached to eating disorders. It seems to many outsiders that someone should just eat something or stop eating, but the mental health issue is far beyond allowing patients to do that. There is definitely spotty coverage when it comes to eating disorders, so check with your personal insurer to see what services you can receive if you need eating disorder treatment.

In the wake of the second Presidential debate last night, it’s as good a time as any to discuss the differences between President Obama and Mitt Romney when it comes to health care. Insurance News Net’s “Report: Romney Vs. Obama’s Health Plans” summarizes a recent report from the Commonwealth Fund. This report, “Healthcare in the 2012 Presidential Election: How the Obama and Romney Plans Stack Up,” says that Romney’s plans would leave 72 million people without health insurance by 2022. I’m not sure Governor Romney would agree with this number, but the Commonwealth Fund’s report took into account the proposals of each Presidential candidate to fix the problems in our healthcare system. They then estimated the amount of Americans who would be uninsured under both plans, divided up by age and income.

Economist Johnathan Gruber performed an analysis of the Affordable Care Act, along with an analysis of two Romney proposals in order to determine the number of uninsured Americans there would be under each plan. Romney’s plans include providing states Medicaid block grants and offering tax incentives for Americans who buy their own individual coverage of health insurance. When you look at Americans 19 and under, 6 million would be uninsured under Obama’s Affordable Care Act compared to 17.9 million under Romney’s plans. The Affordable Care Act would leave 3.3 million middle-class families uninsured, while 17.7 million would be uninsured under Romney’s plans. Families of at least 4 making less than $32,000 a year would be the hardest hit. Obama’s plans leave 17.2 million of them uninsured and Romney’s will leave 38.7 million without health insurance.

Under the Affordable Care Act, those purchasing health insurance through exchanges or individual companies like Aultcare are estimated to spend around 9.1% of their income on their health care costs. Under Governor Romney’s health plans that repeal the Affordable Care Act, individuals are estimated to spend either 14.1% or 18.1% (depending on potential tax breaks) on their health care costs. This economic report doesn’t take other changes that could be made by either President into account, so job growth and Medicare changes could effect these statistics differently. But it is interesting to see the comparison between the two potential outcomes taking only their health care plans into account.

According to Fox News’ “Is your boss watching your cholesterol?,” many companies are offering not only discounts for employees who stay healthy. In some cases, they are also penalizing those who have poor health habits like smoking. Some recent examples include receiving a $50 bonus if you go to a health screening, having your health insurance premiums lowered if you stop smoking, and receiving contributions to an HSA if you lower your weight or cholesterol. If you work at Wal-Mart, you could be charged $10 every pay period for being a smoker. Many may question the validity of these practices, but with health insurance costs through the roof, every little thing to keep employees healthier and deter unhealthy behavior adds up to savings on health care costs.

Last year, 54% of companies were offering some type of financial incentive for good health. By this year, that number has climbed to 61% of employers offering some type of a plan. One-fifth of companies are giving penalties for poor health decisions, a slight increase of 1% from last year. One of the most shocking increases is for the amount of employers using actual statistics to measure employee health and offer their discounts. Last year. only 4% were looking at statistics like BMI and blood pressure. Twenty-five percent of companies are now using these biometric measurements, also for cholesterol and weight numbers. While it’s in the best interest of everyone involved for employees to improve their health and lower health insurance costs for employers and insurance companies, some wonder if this is too much control over our lives. There could be legal issues based on who is running the program and how well they keep it confidential.

Smoking is the biggest health issue being tackled by employers with their employees. Thirty-five percent of companies offer discounts to non-smokers or free programs to help their employees stop smoking. While most companies work on the honor system, it is simple to test employees for nicotine if they so desire. Health insurance costs per employee average $11,664 each year in 2012. That is up from $10,982 last year, but is expected to increase an average of 7% next year as well. Wal-Mart contends that non-smokers’ health care costs are 25% less than those of smokers, so employers have a vested interest in employees’ health. By encouraging employees to be healthier, you also can reduce the rate of absences and even increase productivity. Companies are legally allowed to reward or penalize employees for up to a 20% difference in their health insurance premiums.